Symptoms: “COVID Toes” and Loss of Smell

On January 20^th, public health officials confirmed the first known case of COVID-19 in the U.S. Since then, more than 100,000 Americans have died from the deadly respiratory virus. Countless health agencies around the world are advising people to look out for certain symptoms, such as shortness of breath, fever, and cough, but doctors and other frontline healthcare workers say unexpected symptoms have been cropping up in cases across the globe as well.

Doctors are Seeing New Symptoms

One of the main difficulties when it comes to diagnosing Coronavirus in patients is that symptoms like fever, cough, and shortness of breath routinely present with a variety of other infections. And because COVID-19 is a new virus, medical professionals are still learning more about it every day. For example, the Centers for Disease Control and Prevention (CDC) recently added headache, sore throat, muscle pain, and chills, or repeated shaking accompanied by chills, to its list of common symptoms. But there are other possible indicators of COVID-19 in patients, like what some doctors are calling “COVID toes” and a loss of taste and/or smell.

According to dermatologists, some patients are experiencing a skin condition that affects their feet and toes. Pernio, or chilblains, is a condition that can cause swelling, a burning, itching, or tender sensation, and pink, purple, or red lesions on the feet and toes. Sometimes the discoloration appears on a person’s hands as well. Pernio is usually common in individuals who spend long periods of time in cold or damp weather, but dermatologists say that it is now popping up in people who live in warm climates and who have been isolating inside and generally avoiding damp conditions. Doctors are also observing other dermatological symptoms in Coronavirus patients, like:

• Morbilliform, a rash that looks like measles. Lesions are typically 2 to 10 mm in diameter and are usually flat or slightly elevated on the skin
• Urticaria, or hives. Hives present as an outbreak of swollen, pale red bumps or plaques that often cause a burning, stinging, or itching sensation

Some dermatologists feel as though pernio should be considered as criteria that allows for someone to get COVID-19 testing since they have seen more cases in the last 3-4 months than in their entire careers. But do not fret: dermatologists want you to know that the pink, red, or purple discoloration that the condition causes usually goes away by itself and is no reason to panic.

Another new symptom that frontline medical workers are seeing a lot of is the loss of taste or smell. Research from an otolaryngologist at UC San Diego Health indicates that approximately every 7 out of 10 patients who test positive for COVID-19 report experiencing a sudden loss of smell or taste. Many patients who are experiencing a loss of smell or taste also report symptoms such as fever, malaise, and fatigue. Healthcare professionals at some facilities are now considering it as a strong marker for the Coronavirus infection. In fact, doctors at UC San Diego are now asking patients if they are experiencing this symptom as a routine part of their intake screening process.

Some patients who test positive for Coronavirus also report having some gastrointestinal problems. Medical data indicates that roughly 10% of COVID-19 patients experience gastrointestinal issues like nausea, abdominal pain, and diarrhea. Certain individuals, like people over 70 and individuals with co-morbidities like diabetes, obesity, or heart disease, are particularly prone to presenting with complaints like these. Because we are still learning about COVID-19 and the symptoms that accompany it, it is critical that healthcare workers and the general public stay updated on possible warning signs.

If you are experiencing symptoms like new loss of smell or taste, pernio (or skin discoloration on the hands or feet), shortness of breath, fever, cough, muscle or body aches, headache, nausea or vomiting, diarrhea, chills, congestion or runny nose, or sore throat, call your doctor to see if you meet the criteria for being tested for COVID-19 or if you should begin to self-quarantine at home to prevent transmitting the virus to others.

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